National Electives Policy Advocacy: Update from your VPA

Hi everyone,

I thought I would break in our new “News” function on the SMSS website and take this time to:

a) bring our student body up to speed on what efforts/decisions have been made regarding the proposed national electives cap policy, and

b) discuss future efforts that will be undertaken by both the VP Academic (me) and the SMSS.

With a national issue such as this electives cap change, I really want to make sure that we are all informed  on the issue so that we can have a clear basis for our opinions, remarks, etc. on how our experience in year 4 and CaRMS should go! At the end of the day, we all want to have the opportunity to be in fulfilling careers and medical school should be our time to maximize our experiences so that we can be fit for residency.

So… what has exactly been done in terms of advocacy efforts by the SMSS?

As you all know, once the policy proposal was learned of by our VP Academic (VPA) in August, the CFMS asked all VPAs from the 17 different medical schools across Canada to survey their student body. Whatever opinion, questions, remarks, etc. collected would then be used by the VPAs to answer a CFMS survey on behalf of their schools; the results would then be discussed amongst both AFMC and the UGME Deans by the CFMS. Therefore, as you all remember, I opened a survey for 3-4 weeks in August and was able to collect results from the Classes of 2018-2022.

The general response from that College-wide survey? Majority of students are against this policy change, don’t believe that 8 weeks is enough time per discipline to explore programs and have a competitive application, and are concerned with implementation and regulation of the cap amongst the Canadian medical schools (recall that it will be implemented nationally if it is passed). These are just a few examples among other concerns that were raised – in other words, don’t worry, I read all of your comments (lol).

We then held a Dean’s Lunch to discuss the national elective caps policy from the Dean’s/UGME standpoint and students were able to express their concerns about the policy. Following this lunch, the Student Curriculum Review Committee (SCRC) of the SMSS sent out a second survey to the students would be affected by this change if it were to pass (i.e. Class of 2021 and 2022). The response to this survey was similar to my College-wide one: majority not in favour, and the same concerns were described.

I had the general response that the Class of 2022/first years weren’t sure exactly what experiences in different specialties are possible and/or offered in clerkship, so I held a “What is Clerkship?” talk and sent out the presentation to both first and second years to read through. I hope it made sense and helped clarify some misconceptions!

The SMSS Executive also had the opportunity to meet with Dean Smith and advocate for the student body based on the surveys that were administered. We were able to clarify the following, so please read carefully:

What is the end-goal of this policy?

This aim of this policy change is not to address the unmatched crisis. Rather, the culture of the electives/CaRMS experience is such that students feel the pressure and need to take year 4 to “audition” for their first choice discipline at various programs. There is therefore a lost opportunity in year 4 to use electives to gain and build on medical knowledge and clinical experience. Ideally, one should be comfortable doing electives in multiple disciplines since it will be useful in both their residency training and their overall careers, regardless of the specialty one is interested in. It is noted that the stress experienced by students is due to the culture of program directors expecting a student to be completely committed to a specialty, and that efforts to gain the previously mentioned broad skill set are not seen in a positive light by some program directors.

Why not implement it for future med students? (e.g. class of 2023).

The issue described above has been going on for many years and UGME Deans decided it was time to act on it and implement changes to benefit students. We clarified that this was not something the student body was aware of for a while and that the news seemed “sudden” for the overall student body. The reason for the implementation in 2021 is that 2 years was a realistic timeline (viewed by UGME Deans) to implement such changes.

Other concerns that were discussed as part of student advocacy:

  • Geographic discrepancy of certain programs being offered at different schools and students studying there/nearby having more opportunity to shadow, network, etc.
  • This change in elective scheduling/planning may make it hard for program directors to differentiate between students since it is likely that students with a common career goal may take electives in similar disciplines.
  • Career mentoring and elective schedule approval procedures differ amongst schools across Canada. This is an issue relevant to the question of regulation of any future policy changes. 

Altogether, Dean Smith is receptive to our concerns and will be taking them to the UGME Dean level.

Lastly, given all the efforts above, the SCRC and VPA joint-penned an open letter to Dean Smith and the Associate Deans (Dr. Blakley, Dr. Stobart, Dr. Taylor-Gjevre, Dr. Nair, and Dr. McKague) to highlight concerns and create an open dialogue between student representatives and the faculty. Future meetings will take place!

Great, that was a lot of words! … Now what? Has a decision been made?

A decision has not been made yet and is set to be discussed in a nation-wide UGME Deans meeting at the end of October.

What else is going to be done in terms of future meetings/advocacy?

  1. The VPA will be having another teleconference in the next two weeks to discuss the student body responses with other VPAs, as well as the position the CFMS will be taking with at AFMC and UGME Deans meetings.
  2. The Western Deans Conference in mid-October is also another opportunity that the VPA will be using to discuss with VPAs from UBC, U of M, U of C, and U of A.
  3. Continue open dialogue between VPA, SCRC, and UGME.

What can I do as a medical student to voice my opinion? Or if I have more questions?

  1. Come talk to me ( if you still have questions and/or are confused, etc. Let’s talk!

In Conclusion…

I know that was really lengthy but I hope that answered all of your questions and helped clear up any confusion! There’s a lot of moving parts and I know it’s frustrating to be in the dark, but I hope with this transparent post we can continue advocacy and work with our faculty to do what is best for us as students. At the end of the day, regardless of what policy goes through, we’ll all be fine when it comes to CaRMS. Get started on different aspects of your application, whether it be doing research, getting involved in student groups, volunteering, shadowing, getting a physician mentor, doing externships, medical student exchanges, practicing your suturing skills, etc.! You can always go to the Office of Career Advising and Mentoring for an appointment to discuss your career goals, CV building, etc. My unprofessional professional advice is to get involved and have an open mind. 🙂



Balsam Arwini

SMSS VP Academic

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